Why are pregnant women susceptible to COVID-19? An immunological viewpoint

• Published in: Journal of reproductive immunology Vol. 139; p. 103122
• Main Authors: Liu, Hong, Wang, Li-Ling, Zhao, Si-Jia, Kwak-Kim, Joanne, Mor, Gil, Liao, Ai-Hua
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.06.2020
• Subjects: Betacoronavirus - immunology; China; Coronavirus Infections - complications; Coronavirus Infections - immunology; Coronavirus Infections - pathology; COVID-19; Disease Susceptibility - immunology; Female; Humans; Immunity; Maternal-fetal interface; Pandemics; Placenta; Pneumonia, Viral - complications; Pneumonia, Viral - immunology; Pneumonia, Viral - pathology; Pregnancy; Pregnancy Complications, Infectious - immunology; Pregnancy Complications, Infectious - virology; Premature Birth - etiology; SARS-CoV-2; China; COVID-19; Pregnancy; Maternal-fetal interface; Placenta; Immunity
• DOI: 10.1016/j.jri.2020.103122
• ISSN: 0165-0378; 1872-7603

•The COVID-19 may alter the maternal symmetrical and local immune responses, and affect the well-being of mothers and infants.•Pregnant women are more susceptible to respiratory pathogens; hence, they may be more susceptible to SARS-CoV-2 than the general population.•We focused on the immunological factor of the susceptibility of pregnant women to COVID-19 and the potential damages to mother and fetus. The 2019 novel coronavirus disease (COVID-19) was first detected in December 2019 and became epidemic in Wuhan, Hubei Province, China. COVID-19 has been rapidly spreading out in China and all over the world. The virus causing COVID-19, SARS-CoV-2 has been known to be genetically similar to severe acute respiratory syndrome coronavirus (SARS-CoV) but distinct from it. Clinical manifestation of COVID-19 can be characterized by mild upper respiratory tract infection, lower respiratory tract infection involving non-life threatening pneumonia, and life-threatening pneumonia with acute respiratory distress syndrome. It affects all age groups, including newborns, to the elders. Particularly, pregnant women may be more susceptible to COVID-19 since pregnant women, in general, are vulnerable to respiratory infection. In pregnant women with COVID-19, there is no evidence for vertical transmission of the virus, but an increased prevalence of preterm deliveries has been noticed. The COVID-19 may alter immune responses at the maternal-fetal interface, and affect the well-being of mothers and infants. In this review, we focused on the reason why pregnant women are more susceptible to COVID-19 and the potential maternal and fetal complications from an immunological viewpoint.